胰岛素样生长因子 (IGF)-1 在衰老和癌症生物学中发挥着重要作用，已知禁食可降低成人血清 IGF-1 水平。然而，随意生酮饮食 (KD) 对 IGF-1 水平的影响仍不清楚。 根据 PRISMA 指南，我们通过系统检索 Ovid、PubMed、Scopus 和 CENTRAL 图书馆直至 2023 年 6 月，对人体试验进行了荟萃分析。符合条件的研究为任何健康状况的成年人开了 KD，确认了酮症，并测量了血清 IGF-1。涉及规定禁食或能量限制的方案被排除在外。纵向计算 KD 组干预前和干预后测量值之间的平均差 (MD) 和 95% 置信区间 (CI)。在符合纳入标准的 12 篇出版物中，有 522 人参与，其中 236 人分配给 KD。干预持续时间为1-20周。十项试验的汇总结果显示，干预后血清 IGF-1 水平显着降低（MD：-24.9ng/mL [95% CI -31.7 至 -18.1]；p<0.0001），各研究异质性较低（I2=27） ％，p = 0.19）。 KD 还与显着降低的空腹胰岛素（MD：-2.57 mU/L [95% CI -4.41 至 -0.74]，p=0.006）和血糖（MD：-7.30mg/dL [95% CI -11.62 至 - 2.98]，p=0.0009），尽管异质性显着。对研究设计、性别、饮食持续时间和肿瘤状态的亚组分析显示没有显着差异。随意 KD（> 55% 脂肪）可有效诱导酮症，并可降低血清 IGF-1 20%、空腹血糖 6% 和胰岛素29%。 IGF-1 的这种临床上显着的减少可以在不需要规定的禁食或严格的热量限制方案的情况下实现。需要进一步调查来探索 KD 对衰老生物标志物和癌症管理的影响。版权所有 © 2024。由 Elsevier B.V. 出版。

Insulin-like growth factor (IGF)-1 plays a role in aging and cancer biology, with fasting known to reduce serum IGF-1 levels in human adults. However, the impact of ad libitum ketogenic diets (KDs) on IGF-1 levels remains unclear.Adhering to PRISMA guidelines, we conducted a meta-analysis of human trials by systematically searching Ovid, PubMed, Scopus, and CENTRAL Libraries until June 2023. Eligible studies prescribed KDs to adults of any health status, confirmed ketosis, and measured serum IGF-1. Protocols involving prescribed fasting or energy restriction were excluded. Mean differences (MD) and 95% confidence intervals (CIs) were calculated longitudinally between pre- and post-intervention measurements for the KD groups.Among twelve publications meeting the inclusion criteria, 522 individuals participated, with 236 assigned to KDs. The intervention duration ranged from 1-20 weeks. Pooled results from ten trials showed a significant reduction in serum IGF-1 levels post-intervention (MD: -24.9ng/mL [95% CI -31.7 to -18.1]; p<0.0001) with low heterogeneity across studies (I2=27%, p=0.19). KDs were also associated with significantly decreased fasting insulin (MD: -2.57 mU/L [95% CI -4.41 to -0.74], p=0.006) and glucose (MD: -7.30mg/dL [95% CI -11.62 to -2.98], p=0.0009), although heterogeneity was significant. Subgroup analyses on study design, gender, dietary duration, and oncological status revealed no significant differences.Ad libitum KDs (>55% fat) effectively induce ketosis and can lower serum IGF-1 by 20%, fasting glucose by 6% and insulin by 29%. This clinically notable reduction in IGF-1 can be attained without the need for a prescribed fasting or severe calorie restriction regimen. Further investigation is warranted to explore the impact of KDs on ageing biomarkers and cancer management.Copyright © 2024. Published by Elsevier B.V.